At a glance: Guinea-Bissau

Prevention and hygiene-awareness efforts aim to stave off cholera in Guinea-Bissau

A nurse at the main hospital in Bissau stands outside of a tent erected by UNICEF to house the influx of cholera patients.

By Sylvana Nzirorera

BISSAU, Guinea-Bissau, 6 October 2008 – Jose Turé is a metal worker here in one of the poorest countries in the world, and his life has been marked by hardship. He left his family behind in the town of Bafata when he moved to Bissau, the capital, in hopes of earning a better living. But the move to the bigger town brought with it a new danger: cholera.

It was a rainy Friday, not long ago, when Mr. Turé’s 12-year-old son, Saliu, who was visiting from Bafata, first complained of feeling a terrible pain in his stomach. Mr. Turé did not realize at the time that it could be cholera.

“I had heard about cholera several times,” he said. “Every year during the rainy season, radios all over the country tell the population about the disease. But I never thought it could come my way.”

Mr. Turé started panicking as his son’s health deteriorated. “Saliu was becoming pale and skinny after only one day,” he recalled. “A young man in the neighbourhood helped me to rush him to the main hospital in Bissau, and when I got there I was stunned by the number of patients I saw in the block they called the ‘cholera wing.’”

Main hospital overwhelmedCholera outbreaks have been a fact of life in Guinea-Bissau for more than a decade. Every rainy season carries with it the threat of a cholera epidemic. The outbreak in 2005 was particularly devastating, with more than 20,000 cases and several hundred deaths.

Saliu, 12, lies with two other patients in the crowded cholera wing at the Bissau main hospital.

Such outbreaks are the unfortunate consequences of the country’s aging water and sanitation infrastructure, much of which dates from the colonial era. Many residents use untreated and non-potable water sources, as only 20 percent of the residents in Bissau have access to tap water. Poor sanitation practices add to the risk of contamination.

Mr. Turé’s son is one of some 9,000 victims of the current epidemic, which has killed at least 160. This year’s outbreak started in May in the south of the country. By July, the epidemic had reached the capital. The main hospital was quickly overwhelmed with new patients.

Raising hygiene awarenessTo help the hospital deal with the influx of patients, UNICEF set up a tent to accommodate them, and is providing more beds and better sanitation.

UNICEF also has trained teams of young people and deployed them to various Bissau neighbourhoods to raise awareness and to train the local population in preventive behaviours. The same teams have been disinfecting water sources and demonstrating water purification methods for local households.

Working with the Ministry of Health and non-governmental partners – including traditional and religious leaders in communities – UNICEF is working to educate the population about cholera. There is stigma around the disease in Guinea-Bissau, and affected people are often too ashamed to go to the health centres for treatment.

A nationwide problemMr. Turé is back at home now with his son, who is recovering. But the boy’s father is thinking of leaving Bissau.

“I think I will soon go back to Bafata, where I will not have these problems,” he said.

Yet such a move may be in vain; cholera is a problem in the countryside, as well. Unprotected wells and rivers, from which more than half of the rural population collect their water, are exposed to external contamination and thus pose a high risk for waterborne disease.